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Fully endoscopic transsphenoidal surgery for functioning pituitary adenomas: a retrospective comparison with traditional transsphenoidal microsurgery in the same institution.
Surg Neurol. 2009 Oct; 72(4):336-40.SN

Abstract

BACKGROUND

The efficacy and the minimally invasive nature of the fully transnasal endoscopic procedure in the treatment of pituitary adenomas and other lesions of the sellar area have been widely reported in the literature. Many authors observed similar results in terms of the correction of hormonal hypersecretion in functioning pituitary adenomas using endoscopic endonasal surgery or the traditional microscopic technique. We report the endocrinologic outcome in 2 series of patients operated on at the same institution for functioning pituitary adenomas using these 2 different techniques.

METHODS

This study includes 2 successive series of 60 consecutive patients presenting with a hormonally active pituitary adenoma operated on by the same surgeon. The surgical results obtained in the most recently operated group using a fully endoscopic endonasal technique were compared with those obtained previously using the traditional microsurgical transsphenoidal procedure. The classification of tumors into 4 grades according to Hardy was based on modern MRI and intraoperative findings.

RESULTS

The overall remission rate of hypersecretion was 63% in the endoscopic group compared with 50% in the microsurgical group. The most obvious difference between the 2 groups was observed in noninvasive macroadenomas. In this specific grade of tumors, the remission rate of hypersecretion obtained using endoscopy was 78% compared with 43% using microsurgery. The endocrinologic results achieved for microadenomas were similar in the 2 groups. Postoperative CSF leaks occurred more frequently (6 cases) in the endoscopic group.

CONCLUSIONS

In our experience, fully endoscopic transsphenoidal surgery for functioning pituitary adenomas leads to a better endocrinologic outcome for noninvasive macroadenomas compared to the traditional microsurgical technique. However, morbidity with the endoscopic technique was higher in terms of the rate of postoperative CSF leaks.

Authors+Show Affiliations

Department of Neurosurgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, B-1090 Brussels, Belgium. jean.dhaens@uzbrussel.beNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19604551

Citation

D'Haens, Jean, et al. "Fully Endoscopic Transsphenoidal Surgery for Functioning Pituitary Adenomas: a Retrospective Comparison With Traditional Transsphenoidal Microsurgery in the Same Institution." Surgical Neurology, vol. 72, no. 4, 2009, pp. 336-40.
D'Haens J, Van Rompaey K, Stadnik T, et al. Fully endoscopic transsphenoidal surgery for functioning pituitary adenomas: a retrospective comparison with traditional transsphenoidal microsurgery in the same institution. Surg Neurol. 2009;72(4):336-40.
D'Haens, J., Van Rompaey, K., Stadnik, T., Haentjens, P., Poppe, K., & Velkeniers, B. (2009). Fully endoscopic transsphenoidal surgery for functioning pituitary adenomas: a retrospective comparison with traditional transsphenoidal microsurgery in the same institution. Surgical Neurology, 72(4), 336-40. https://doi.org/10.1016/j.surneu.2009.04.012
D'Haens J, et al. Fully Endoscopic Transsphenoidal Surgery for Functioning Pituitary Adenomas: a Retrospective Comparison With Traditional Transsphenoidal Microsurgery in the Same Institution. Surg Neurol. 2009;72(4):336-40. PubMed PMID: 19604551.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fully endoscopic transsphenoidal surgery for functioning pituitary adenomas: a retrospective comparison with traditional transsphenoidal microsurgery in the same institution. AU - D'Haens,Jean, AU - Van Rompaey,Katrijn, AU - Stadnik,Tadeus, AU - Haentjens,Patrick, AU - Poppe,Kris, AU - Velkeniers,Brigitte, Y1 - 2009/07/14/ PY - 2009/01/19/received PY - 2009/04/09/accepted PY - 2009/7/17/entrez PY - 2009/7/17/pubmed PY - 2009/11/18/medline SP - 336 EP - 40 JF - Surgical neurology JO - Surg Neurol VL - 72 IS - 4 N2 - BACKGROUND: The efficacy and the minimally invasive nature of the fully transnasal endoscopic procedure in the treatment of pituitary adenomas and other lesions of the sellar area have been widely reported in the literature. Many authors observed similar results in terms of the correction of hormonal hypersecretion in functioning pituitary adenomas using endoscopic endonasal surgery or the traditional microscopic technique. We report the endocrinologic outcome in 2 series of patients operated on at the same institution for functioning pituitary adenomas using these 2 different techniques. METHODS: This study includes 2 successive series of 60 consecutive patients presenting with a hormonally active pituitary adenoma operated on by the same surgeon. The surgical results obtained in the most recently operated group using a fully endoscopic endonasal technique were compared with those obtained previously using the traditional microsurgical transsphenoidal procedure. The classification of tumors into 4 grades according to Hardy was based on modern MRI and intraoperative findings. RESULTS: The overall remission rate of hypersecretion was 63% in the endoscopic group compared with 50% in the microsurgical group. The most obvious difference between the 2 groups was observed in noninvasive macroadenomas. In this specific grade of tumors, the remission rate of hypersecretion obtained using endoscopy was 78% compared with 43% using microsurgery. The endocrinologic results achieved for microadenomas were similar in the 2 groups. Postoperative CSF leaks occurred more frequently (6 cases) in the endoscopic group. CONCLUSIONS: In our experience, fully endoscopic transsphenoidal surgery for functioning pituitary adenomas leads to a better endocrinologic outcome for noninvasive macroadenomas compared to the traditional microsurgical technique. However, morbidity with the endoscopic technique was higher in terms of the rate of postoperative CSF leaks. SN - 1879-3339 UR - https://www.unboundmedicine.com/medline/citation/19604551/Fully_endoscopic_transsphenoidal_surgery_for_functioning_pituitary_adenomas:_a_retrospective_comparison_with_traditional_transsphenoidal_microsurgery_in_the_same_institution_ DB - PRIME DP - Unbound Medicine ER -